Angiotensin II Receptor Blockade Reduces New-Onset Atrial Fibrillation and Subsequent Stroke Compared to Atenolol. The Losartan Intervention for End Point Reduction in Hypertension (LIFE) Study

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Niedawna analiza bazy danych z duńskiej opieki zdrowotnej, w ramach której prowadzono długoterminowe monitorowanie wpływu różnych leków hipotensyjnych na występowanie jawnego AF, wskazuje na korzystny wpływ inhibitorów ACE i ARB [245]. We wtórnych analizach dotyczących stosowania inhibitorów ACE i ARB u pacjentów z niewydolnością serca lub przerostem lewej komory stwierdzono mniejszą częstość występowania nowego AF [238,246]. U pacjentów z AF bez dysfunkcji lewej komory ani niewydolności serca ARB nie zapobiegają nawrotom AF lepiej niż placebo [240,241].…”

Hypertension and cardiac arrhythmias: a review of the epidemiology, pathophysiology and clinical implications

“…In the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study, ARB-based therapy (losartan) was associated with a 33% reduction in the incidence of AF and with a significant reduction in the incidence of subsequent stroke compared with b-blocker-based therapy (atenolol). 73 Similarly, in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) Trial, ARB-based therapy (valsartan) had a 16% risk reduction in the incidence of AF compared with CCB-based therapy (amlodipine) after adjustment for confounding covariates. 71 In patients with concomitant hypertension and AF, ARB-based therapy (losartan) in combination with amiodarone was also more effective than CCB-based therapy (amlodipine) in preventing the recurrence of AF.…”

Targeting the renin–angiotensin–aldosterone system in atrial fibrillation: from pathophysiology to clinical trials

“…Combined data from the three hypertension trials (the Losartan Intervention for End Point Reduction in Hypertension (LIFE) new-onset AF substudy, Second Swedish Trial in Old Patients with Hypertension (STOP)-2 (STOP-2) and Captopril Prevention Project (CAPP)) that reported the effects of RAAS blockade and AF prevention failed to show a statistically significant reduction in AF (RRR 12%; P ¼ 0.4). [35][36][37] However, the LIFE new-onset AF substudy, 35 which did use the ARB losartan, did demonstrate a significant reduction in AF, despite similar blood pressure reductions among the 9193 patients with hypertension and ECG-LVH who were randomised to a losartan or atenolol-based treatment strategy. The patients presenting with new-onset AF had two-, three-and five-fold increased rates, respectively, of cardiovascular events, stroke and hospitalisation, which were reduced by losartan treatment compared to atenolol.…”